Further to Your Freedom of Information Request

Information Required FOIA Reference Number: FOIA160604

Date FOI Received: 03/06/2016

Date FOI Response by: 01/07/2016

Further to your Freedom of Information request

Subject: erectile dysfunction service provision We are conducting a project on service provision for men with Erectile Dysfunction, with the overarching aim of helping to improve services for men across England, Scotland, Wales and Northern Ireland. NHS East and North Hertfordshire CCG’s response is: Response: Q1. Does your Health board provide an erectile dysfunction clinic and can you provide the total number and addresses of all NHS erectile dysfunction clinics within your Health board? If you do not know who should we ask?

Q2. Does your Health board provide psychosexual clinics and can you provide the total number and addresses of all NHS psychosexual clinics within your Health board? If you do not know who should we ask?

Q1. & Q2. Response: NHS East and North Hertfordshire Clinical Commissioning Group do not hold the requested information. Erectile Dysfunction clinics are commissioned at (i) East and North Hertfordshire NHS Trust, (ii) The Princess Alexandra Hospital NHS Trust, (iii) Royal Free Hospital some or all of this information may be held by these NHS organisation please contact them for further information

The CCG would therefore advise you to submit your FoI request to: (i) East and North Hertfordshire NHS Trust using the following signposting - [Freedom of Information enquiries]: [email protected] (ii) The Princess Alexandra Hospital NHS Trust using the following signposting - [Freedom of Information enquiries]: [email protected] or post to FOI Department, Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX (iii) Royal Free Hospital using the following signposting - http://www.royalfree.nhs.uk/contact-us/freedom-of-information-act-requests/

Q3. Does your Health board provide counselling and sex therapy services and can you provide the details of any NHS counselling services and sex therapy services that treat men with erectile dysfunction within your Health board? If you do not know who should we ask? Response: the CCG do not currently commission specific sex therapy services or sex therapy services that treat men with erectile dysfunction within its health board. The CCG however, commissions Improving Access to Psychological Therapies (IAPT) for patients who present with symptoms of anxiety and/or depression.

Q4. Does your Health board provide PDE5-I and if so which one? Response: The CCG recommendations on PDE5 use in line with Schedule 2 to the NHS (General Medical Services Contracts)(Prescription of Drugs etc) Regulations 2004 are here: http://www.enhertsccg.nhs.uk/sites/default/files/content_files/Prescribing/Local_Decisions/Obstetr ics_gynaecology_and_urinary_tract_disorders/PDE-5%20inhibitors%20for%20ED%20- %20Hertfordshire%20Prescribing%20Guidelines%20201505.pdf

Q5. Does your Healthboard prescribe ‘tadalafil (Cialis)’ tablets for men who experience erectile dysfunction as a result of prostate cancer treatment? Response: Please refer to (Q4) – erectile dysfunction associated with prostate cancer is a specified indication under the Schedule. GPs can prescribe and although the CCG may know whether tadalafil has been prescribed or not, from the data we would not know the exact reason and whether this was as a result of prostate cancer.

Q6. At what dose are the ‘tadalafil (Cialis)’ tablets prescribed? Response: The on-demand dosing of tadalafil (10mg or 20mg) is recommended. The daily dose formulations of 2.5mg or 5mg are not recommended by Hertfordshire Medicines Management Committee. Please also refer to (Q7).

Q7. Is the daily dose of ‘tadalafil (Cialis)’ tablets (2.5/5mg) available/prescribed? Response: Prescribing data is available in the public domain from the Health & Social Care Information Centre all prescribing data is now in the public domain and can be located on the Health & Social Care Information Centre (HSCIC) website: http://www.hscic.gov.uk/article/2021/Website-Search?q= %22clinical+commissioning+group+prescribing+data %22&infotype=13367&sort=Relevance&size=10&page=1&area=both#top However, to assist, the CCG can confirm that in April 2016 (3.57%) of prescription items for the management of erectile dysfunction(ED) were for tadalafil 2.5mg or 5mg tablets. It is not possible to tell from epact data exactly how many prescriptions were for daily use, since some patients may have received it as an off-label prescription for on-demand use where they could not tolerate higher doses or other PDE5I drugs.

Q8. Does your Health board prescribe the Vacuum erection device for men who experience erectile dysfunction as a result of prostate cancer treatment? Response: the vacuum devices – these are prescribable on FP10 but the CCG would usually advise the GP that if this has been recommended by the specialist service at East and North Hertfordshire NHS Trust, The Princess Alexandra Hospital NHS Trust, Royal Free Hospital as part of a referral, they should supply the device and train patient on use.

Q9. Does your Health board offer Penile implant surgery (semi-rigid or inflatable implant devices) for men who experience erectile dysfunction as a result of prostate cancer treatment? Response: The CCG has a public Bedfordshire & Hertfordshire Priorities Forum Policy on its website http://www.enhertsccg.nhs.uk/document-type/priorities-forum-final-and- interim?page=5 The policy on penile prostheses for erectile dysfunction states: ‘Surgery should only be carried out at specialist tertiary centres which collect and publishes outcome data and post-operative complications of any cases performed (seek advice from specialist commissioning).’

Exemption – Q4, Q9

Exemption Applied: Section 21: Information Accessible By Other Means Information available on the CCG website is not attached here under Section 21: Information available to the applicant through other means.

Please note that the information provided remains the property of NHS East and North Hertfordshire CCG and is therefore subject to Intellectual Property and Database Rights. In view of the Re-use of Public Sector Information Regulations, should you wish to re-use this information for commercial reasons, you are advised to obtain permission from us. Agreement to use the information for commercial reasons may incur a fee as the information is issued under licence. If you have any questions about the process, please do not hesitate to contact me in the first instance.

If you require further information please contact me [email protected]

If you are dissatisfied with this response or wish to appeal, please write to: Company Secretary Governance & Corporate Affairs NHS East and North Hertfordshire CCG Charter House Parkway Welwyn Garden City AL8 6JL.

If you are dissatisfied with our response, you may appeal to the Information Commissioner whose contact details are available at http://www.ico.gov.uk, together with further information about the Freedom of Information process.

Regards Freedom of Information Administrator